Clinical findings of HCV chronic infection in undocumented immigrants and low-income refugees in three areas of southern Italy

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Clinical findings of HCV chronic infection in undocumented immigrants and low-income refugees in three areas of southern Italy

Authors

Sagnelli, E.,Alessio, L.,Sagnelli, C.,Gualdieri, L.,Pisaturo, M.,Minichini, C.,Di Caprio, G.,Starace, M.,Onorato, L.,Scotto, G.,Macera, M.,Coppola, N.

Citation
2018
Annals of Hepatology

17

1
47-53
Type
Prospective cohort
Virus targets
Hepatitis B
Hepatitis C
Other targets
HIV
Interventions
HCV testing and linkage to Care
Linkage to care
Screening and diagnosis
Testing
Setting
National
Target populations
Immigrants/Refugees
Country of development
Italy
Target location
Italy
DOI
10.5604/01.3001.0010.7534
Testing strategy
Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test
Laboratory-based antibody test
Laboratory-based PCR/RNA (confirmatory) test
Countries of included studies
Italy

Health outcomes

Receipt of antibody results,Linkage to care,Diagnostic test accuracy information

Testing Strategy

Laboratory-based antibody test,Laboratory-based PCR/RNA (confirmatory) test

Abstract

Introduction and aim. In recent decades, Italy has become a land of immigration from countries suffering a socio-economic crisis. The aim of this study was to perform an organized screening to identify and offer care to immigrants with HCV infection. Material and methods. The screening, performed from 2012 to 2015, involved 1,727 immigrants in the Campania and Apulia regions in southern Italy. Results. Screening was accepted by 1,727 (85%) out of 2,032 immigrants interviewed; 70 (4.1%) of the 1,727 were anti-HCV-positive, all unaware of their serological condition, 31 (44.3%) of whom were HCV-RNA-positive and 39 negative. The 31 HCV-RNA-positive immigrants were further investigated at a third-level clinic of infectious diseases. The HCV viral load was 2.6 x 10<sup>7</sup> +/- 7.7 x10<sup>7</sup> IU/mL, and 35.5% showed HCV-genotype 1a or 1b, 23.8% genotype 2 and 22.6% genotype 3. Two immigrants had liver cirrhosis and, in accordance with the Italian Healthcare Authority guidelines, received an interferon-free regimen and achieved a sustained virological response (SVR); 18 had chronic hepatitis, 6 of whom with a high risk of progression and received interferon-based therapy, with SVR in 4, whereas 12 at low risk were put on a waiting list for future interferon-free treatment, once licensed. The remaining 11 HCV-RNA-positive immigrants were considered HCV inactive chronic carriers and were included in a long-term observational program. Conclusion. The screening program can be considered successful since it was accepted by 85% of the subjects interviewed and identified 70 anti-HCV-positive immigrants, all unaware of their clinical and virological condition. Copyright © 2018, Fundacion Clinica Medica Sur. All rights reserved.

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22 Jan 2021